The American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) has introduced a new groundbreaking set of guidelines to enhance infection prevention in regional anesthesia and interventional pain medicine procedures. Developed over four years, these recommendations address infection control practices for procedures such as nerve blocks and implantable pain therapies, filling a critical gap in patient safety protocols. The guidelines stem from expert collaboration and respond to ASRA Pain Medicine surveys that highlighted inconsistencies in infection prevention approaches. By outlining best practices, the initiative aims to reduce infection risks, improve complication management and support standardization in the field.
In 2020, ASRA Pain Medicine commissioned evidence-based guidelines for best practices for infection control. Over 80 research questions were formulated, with systematic literature reviews conducted by specialized working groups. The guidelines were structured using modified US Preventive Services Task Force criteria to assess evidence strength and certainty.
A modified Delphi method facilitated consensus, requiring over 50% agreement for a recommendation to proceed to author review and over 75% agreement for final acceptance. The ASRA Pain Medicine Board of Directors conducted a thorough review before approving the final guidelines.
The guidelines comprehensively address infection risks associated with regional anesthesia and interventional pain procedures, including implanted devices. Key recommendations focus on:
- Preoperative risk assessment: The role of the anesthetist and pain physician in infection control
- Sterile techniques and equipment maintenance: Best practices for reducing microbial contamination
- Infection prevention across clinical settings: Considerations for hospitals, outpatient clinics and office-based practices
- Postoperative risk reduction and early detection: Protocols for infection symptoms, diagnosis and treatment
These updated guidelines align with CDC research, which emphasizes the need for proper protocols in preventing surgical site infections. They are required to be reviewed continuously to align with emerging research and clinical advancements. ASRA Pain Medicine encourages interdisciplinary collaboration and clinical decision-making to integrate these recommendations into routine practice, supporting safer patient outcomes in regional anesthesia and pain medicine.Â
References
Provenzano DA, Hanes M, Hunt C, et al. ASRA Pain Medicine consensus practice infection control guidelines for regional anesthesia and pain medicine. Regional Anesthesia & Pain Medicine. Published Online First: 20 January 2025. DOI: 10.1136/rapm-2024-105651
Disclosure: This article was created by the touchINFECTIOUS DISEASES team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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